| NPI | 1407921018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 161304) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD20193) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2025-03-26 |